Wednesday, January 31, 2007

16w5d - Boy oh BOY!

Had the big ultrasound today and we were right, that was a penis we saw 3 weeks ago! He's still all boy and looking great! Measuring about 1.5 weeks ahead and bladder looks good too.

This is the "money shot". I'm not good at photoshoping to put a nice arrow at the right spot, but if you see the black area that's sort of shaped like a crescent wrench, in the crescent area - the white part is the penis.

Here's a cute shot of his left foot.

And here's a nice profile, head on the right. That's his arm laying above his tummy.

Now, to find a name for this guy. He had the hiccups during the u/s and we've got a VHS tape of it, but have to get Hubby to encode it to digital so we can share it.

Speaking of Hubby, poor guy has the flu. Not the tummy variety, but the "Did you get the license of the truck that hit me?" type. Luckily, he listened to me and went to the Dr. yesterday and is on an antiviral now so hopefully he'll get better soon. NSWO and I both had the vaccine, so hoping this strain was covered by that. Especially since I can't take anything for it if I do get it.

Saturday, January 27, 2007

16w1d - Belly pic & NSWO update

This was taken today 16w1d. By the end I'm going to be HUGE again!
I got my first official kick on Thursday. I've felt little thumps and bubbles and even some rolling, but that was the first decent kick. Made me smile. It's odd to think that with NSWO I didn't feel anything until after 20 weeks and now I'm already feeling this much. I'm also getting some mild Braxton Hicks contractions too. Didn't get them this early with NSWO. This pregnancy is just so different.
In other news, NSWO was so cute yesterday. I was busy vacuuming downstairs and he was upstairs being a bit too quiet. At one point, I turned off the vacuum and he came to the stairwell to give me a status report. "Hey MOM! I was playing with your shoes and trying them on, and then I was jumping on your bed, and then I turned on my favorite movie in the office!" I had to stifle my laugh at ratting himself out and asked him to 1) put my shoes back on the shelves, 2) remind him of why we don't jump on beds, and 3) ask him if he had turned off the TV. How can you get mad at him for doing 3 things he isn't supposed to do when he so excitedly tells you about them?
We are getting him a new bed soon. After the u/s on Wednesday we'll hopefully know for sure which room he's going into (staying in his if this one is a girl, and moving into the current guest room if it's another boy) so we can schedule delivery of the furniture. I found a killer deal on a twin bed with trundle drawer, nightstand and 5 drawer chest for less than $900! Sweet! And it's neutral enough in finish that if this one is a girl (yeah, right!) she can use it in the future. If it's another boy, they can share a room too and The Bean can sleep on the trundle. I had to remind NSWO that if he jumped on his new BIG BOY BED that he might get hurt or he might break his bed. I told him that the only thing he's allowed to jump on is a trampoline, asked him if a bed is a trampoline ("No.") and said he'd have to wait until he gets a trampoline someday. Little does he know that there is one on the way right now from Grandad! (Thanks Grandad!) We tried to get it last year for christmas but it was backordered. Same thing this year so we bit the bullet and decided to go for it anyway and it should be here next week. The kid is going to have sooo much fun! Here's a link to it:
Too bad it only goes to 88lbs. Bummer.

Friday, January 26, 2007

16w0d - Neo ain't got nothin' on me!

You know the scene in The Matrix where Neo dodges the bullets? Well, he's not the only one with this skill. Heck, I even had a dream about dodging bullets a few months back. Apparently, it was more prophetic than I thought.

A bit of history first. This pregnancy resulted from a dodged IVF bullet. Then, we had the scare with The Bean's bladder, but turns out we dodged that one too. Now, I have a third (and hopefully last) bullet that we've dodged.

After my OB appointment last Friday, I got a call from my OB. He'd been going over my records that were transferred from the MW upstairs that I'd seen at 8wks. At that appointment, the MW had me do the basic OB bloodwork panel. In those test results my new OB saw that I had tested positive for the anti-Jk antibody. (Huh?) He wanted me to get some more blood drawn to double check and to measure the amount of antibodies in my blood. I was taking NSWO to swim class so I didn't have time to ask much more so I got straight to work researching this issue when I got home. What I found wasn't very good.

Bear with me, this is fairly complicated, but I'll try to explain as best as I can. Most people are aware of the Rh blood grouping system. Most people are positive for Rh (A+, AB+, O+, etc.) but some are Rh negative (A-, B-, O-). There is a protein on the red blood cell's surface that determines your Rh status. There are other proteins on the red blood cell as well and one of them is called Jk, from the Kidd group. About 15% of the population is Rh- and the number of people with blood that is Jk- is far smaller (maybe 1-2%). If the mother is Jk- and her partner is Jk+ there is a chance that the baby could be Jk+ as well. If the blood between mother and fetus mixes, the mother's body will see the presence of the protein as a foreign invader and develop antibodies to it. Most women who are Rh- get an injection called Rhogam to prevent these antibodies from being formed by her body. Unfortunately, there is no equivilant injection for people who are Jk-.

If the mother develops antibodies to the blood of her fetus, it is more likely to affect subsequent pregnancies if the next fetus is also Jk+. The antibodies she makes are small enough to pass thru the placenta to the baby and they start attacking the protein on the fetus' red blood cells causing them to explode. This causes anemia for the baby because it has too few red blood cells to carry oxygen to the body's cells. Depending on how much antibodies the mother is making it can have anywhere from no effect up to a severe effect on the fetus. If the level of antibodies gets too high, they have to monitor the baby for effects. The old way of doing this was repeated amnios every few weeks. Luckily, there is a better way that isn't nearly as invasive. Using doppler imaging with ultrasound they can measure how fast the blood is flowing thru the middle cerebral artery of the baby. If it's too fast, that means the blood is too thin so the heart is working harder to get the oxygen where it needs to go. If that happens, they will often need to perform an IUT (intra-uterine tranfusion - giving the baby new blood via the umbilical cord while in utero) of the baby to give it less anemic blood that the mother's body doesn't see as an invader (Jk- blood). Over time, the baby's bone marrow will replace the baby's blood and the mother's antibodies will attack again. IUTs may need to be repeated until the baby is big enough to be delivered early, often around 34 weeks gestation. (Full-term is 40 weeks). Sometimes, the baby will need another transfusion after birth and can suffer from HDN (hemolytic disease of the newborn) including severe jaundice as well as the other risks associated with premature delivery. These babies can spend weeks in the NICU trying to recover. Most do well, but it isn't an easy road for the pregnancy or the newborn.

So, after all that doom and gloom, back to my original point, we dodged another bullet. The lab results came back from Monday's blood draw and apparently there are no anti-Jk antibodies in that sample. Since the original test went to a different lab, there's a chance that it was lab error or perhaps there are so little of the antibodies in my blood that they are not showing up at this point. In any event, we have been cleared of this possible complication and couldn't be happier about that. Now, I'm just hoping that we don't need to dodge anything else, but at least I'm getting good at it.

Tuesday, January 23, 2007

15w4d - OB appt update

My appt was actually Friday, but I haven't gotten around to updating yet. Sorry.

Everything went well. My OB does not want to move my due date up though since he prefers to go by the early u/s dating which puts my due date back at July 13. Oh well, guess I don't get to lose that week of pregnancy after all.

Great news is that once I reminded my OB about having already done the 1-hour glucose screening test and passing, he said that I don't have to repeat until 28weeks! Yay!!! I'll probably start checking my fasting blood sugar level at about 20 weeks or so a few times a week to see if it's going up, hoping that it doesn't. The fasting number was always the one I had the hardest time controlling last time.

Baby's heartrate was 140bpm which just reaffirms my belief that it's a boy.

I have another u/s at the perinatologist on the 31st.

Feeling mostly good these days, still a bit tired sometimes, but not nearly as bad as it was with NSWO. My hips are already achey while I'm sleeping so I'm hoping that yoga will help keep that mild for a while longer. I've started feeling this little one moving a bit which is really cool. I didn't feel NSWO until after 20wks due to my anterior placenta and it's so neat to be feeling this one so much earlier.

Wednesday, January 10, 2007

13w5d - Ultrasound pics - a retrospective

I finally got the scanner up and running, so here's the history to date of ultrasound pics.

This first one is at 6w5d and, granted, doesn't look like much. The circle in the upper left corner is the yolk sac and the blob at the bottom center is the Bean. The yolk sac provides nourishment for the baby until the placenta is large enough to take over that job.

This 2nd one is at 8w5d and you can more clearly see the yolk sac (it's smaller now as the placenta is growing and will take over nourishment of the baby soon.) The Bean is the bigger blob on the left of the big black circle (the gestational sac).

This third pic is from 12w2d. I was technically 11w3d by ovulation date, but baby was already measuring big so they moved my due date up. Here, finally, the Bean is starting to look like a baby - albeit with a VERY big head. The head is on the right, the rest of the body is sort of curled up on the left. You can see the sort of dotted line across the bottom that is the spine. Squint and you can see it better. LOL

The fourth and fifth ones are from this week at 14w2d. We didn't get any print outs last week, but that's ok, my bladder was so full, all I wanted to do was be done and find a bathroom!

In this one, you can get a much clearer profile of the Bean. What a cute little nose!!!

This last one is my favorite. It's, again, not extremely clear, but you see that little blob in front of it's face? That's the Bean sucking it's thumb. How cute is that???

The other news from yesterday's ultrasound is that the bladder was even smaller. In fact, the tech had to hunt around a bit to get a good view to be able to measure it. We're very happy that this scare seems to be behind us. We go back in 2 more weeks for an anatomy scan where they will take a longer look and measure several parts of the Bean. We expect that at that ultrasound they will also confirm that we are having another boy. Yes, Hubby and I are about 90% sure we saw a penis yesterday while the tech was looking around to measure the bladder. At one point, the view was as if the Bean was sitting on the camera lens. This is the same view we got of NSWO at 14 weeks that confirmed he was a boy, so we're pretty sure of what we saw. Granted, the tech didn't confirm anything, but he also wasn't trying to look for gender. I'll guess we'll see for sure in a couple of weeks.

I admit to being a bit saddened by this news. Not because the baby is a boy (not at all!), but because this is/was my last chance of ever having a little girl. I know that in the long-term I will grow to appreciate that not having a girl is going to be better - no teenage girl drama!! - but I am sad about missing out on the short-term fun parts. The shopping for pink stuff, playing dolls with her, taking my daughter to ballet class.

My best friend who had identical twin girls in September suggested we should arrange the marriages now. Her girls to my boys. I hope the kids don't mind too much not being able to choose who they marry. Ahh, they'll get over it! Don'tcha think?

Monday, January 08, 2007

13w3d - belly pic

You're not going to see a belly shot here with any exposed skin. I wouldn't subject you to that. NSWO's pregnancy did a number on my belly and the road map of stretch marks are just not pleasant.

Instead, I'll try to keep updated on clothed belly shots.

Here's a 13 week shot.

Friday, January 05, 2007

13w0d - Combined screen results are in.

We had the NT scan about a week or so ago and at the same time, they took a sample of blood to run some tests. That info was combined with the NT measurement, the size of baby in terms of dates, and my age to give us an adjusted risk for Downs Syndrome and other trisomies and birth defects.

I don't have recorded anywhere the NT measurement with NSWO's pregnancy, but I do have what we got for adjusted odds with his pregnancy.

Downs Syndrome adjusted risk: 1/5100
Spina Bifida adusted risk: 1/4600
Adjusted risk for other trisomies: negative (risk was less than 1%, no fractional odds given)

NSWO turned out just fine.

Now, on to this current pregnancy. For The Bean, we got:

NT measurement = 1.7mm.

My age based risk for Downs Syndrome is 1/374.
My adjusted risk for Downs Syndrome is 1/7461.

My age based risk for other trisomies and birth defects is 1/667.
My adjusted risk for these is 1/13,321.

No need for an amnio or CVS. I can't stop smiling. Not that I expected there to really be an issue, especially after the great NT measurement, but when you're diagnosed with diminished ovarian reserve, they emphasize to you that running out of eggs also can mean that what you have left is the bottom of the barrel and might not be any good. I guess we showed them! My 33 yr old egg seems to be a better risk than my 29 yr old egg was!

Tuesday, January 02, 2007

12w4d - Ultrasound update

We had a follow-up ultrasound today (12w4d, baby is measuring 13w2d) to check on the baby's bladder. Last week it was measuring at 8mm - too big. We are very happy to report that today, the bladder was 6.7mm - nearly within normal range. We will go back next week for another look just to confirm that the bladder stays 'normal' but the perinatologist today said that he is very confident that everything is going to be just fine. Whew!

Monday, January 01, 2007

12w3d - 2006 - A Year in Review

So, as I sit here on January 1st, it seems only appropriate to take a look back at this last year and think about what 2007 might bring.

January 2006
This is when the bad news really started to roll in. After approximately 18 months of TTC a 2nd child, we had our first appointment with an RE (reproductive endocronologist - fertililty specialist). I had done 3 rounds of Clomid with no luck. At least I was sure I ovulated on the crap, but otherwise, it was NOT a good drug for me. I was moody and the hot flashes really sucked. After some basic testing (cd3 bloodwork) I got some seriously crushing news. My cd3 FSH level was 16.5 - this is not good. I'm officially diagnosed with Diminished Ovarian Reserve, nearly a death sentence in the world of infertility. My consultation with Dr. Google gives me nothing but a poor prognosis and talk of donor eggs. I start to believe that my dream of a 2nd child is all but over. Luckily, I also started seeing Lee, my acupuncturist, in January and saw that there might be a bit of light at the end of this tunnel. She helped me to start believing that FSH is just a number and not what defines me.

February 2006
We got yet another bit of bad news. The RE decided not to waste the Clomid I took for the CCCT and do an IUI. Since I'd been pregnant twice already by Hubby, we had no reason to suspect that there could be a problem there too. But alas, there was. The sperm count came back miserably low - post-wash was a mere 800,000. Most REs won't do IUI if the count is below 2 million. We were significantly below that, but since the sperm was already ready to go, we did the IUI anyway. We were crushed to realize that this was not likely to be our magic bullet.

March 2006
We re-group and decide to get going with IVF as soon as possible to not waste any more of my eggs. We have a trip to Hawaii already planned and it looks like my cycle isn't going to cooperate to allow us to start the IVF, so I go on progesterone suppositories to attempt to lenghthen my cycle so we can start the IVF upon our return from vacation. On the day of my last bit of pre-IVF testing (mock transfer & final bloodwork) I decide to take a hpt on a whim, just in case. Lo and behold, it's a BFP! Are you serious? We're supposed to not be able to do this on our own! Since I'm already at the clinic, they do a beta - it's a 6. Levels have to be above 5 to be considered positive. I'm not even worried about the level because I'm so surprised it was positive at all. Betas jump up nicely in the following days and we head to Hawaii on cloud 9.

April 2006
Hawaii was a blast and we anxiously await our first u/s to see this little bean. Finally, it's time and we see one baby with a heartbeat! Hubby is very happy, my RE, not so much. The baby is measuring several days behind where it should be and the heartrate is very low - 81bpm. I can tell from the look on her face that she doesn't expect this to go well, but they have us come back in a week to see. THE LONGEST WEEK OF MY LIFE. My acupuncturist helps me to 'get out of my head' and listen to my inner voice. I wake up one morning hearing a female voice telling me, "This pregnancy isn't going to make it, but it will be ok." Surprisingly, this brings me peace.

May 2006
Our second u/s showed that the heart had stopped and the gestational sac was already beginning to collapse. The D&C is scheduled for the next day, May 5. Happy friggin Cinco de Mayo to me! The next few days/weeks are a bit of a blur, filled with lots of tears and anger and hopelessness. Not a good time.

June 2006
My period shows up 28 days after the D&C, at least one thing was normal about the process. My RE wants me to have one more normal cycle before IVF so we wait. We get the karyotyping results back from the D&C - a normal baby girl. No known cause for the loss.

July 2006
Still waiting. No AF after 30 some days so my RE has me come in to take a look at what's going on. Here begins the battle with the cysts - 35mm on the right ovary. We decide to use an hCG trigger shot to get the cyst to pop so I can start IVF once we get back from a trip to the New Jersey shore for a family reunion. I also find out that my mom has 2 clotting disorders, Protein C & S deficiencies. Testing will later show that I have neither of them, thankfully. While in NJ, my period shows up too early and is heavier than I've ever experienced. No way to get cd2 monitoring done, so we have to wait another month to do IVF.

August 2006
Once again, my cycle goes beyond 30 days so off I go to the RE to take a look. This time the cyst is 30mm and estrogen is low, but we trigger again anyway and hope for the best. AF shows up and I go in for cd2 monitoring. The cyst is still there, but it's down to 15mm (just at the cut-off) and we decide to go ahead with the bcp for the IVF. My FSH has gone up a bit to 16.9, but whatever.

September 2006
After 11 days of bcp, I go in for suppression check to see how things look and WTF? the cyst isn't gone and it's recruited a friend - 23mm & 28mm. I have the buggers surgically aspirated and my protocol gets switched from MDL (micro-dose lupron) to Antagonist which I'm very happy about. 2 days later, we take another look and the 2 cysts are smaller, but not gone and there is a 3rd one popping up! All of this was for naught though as after 5 days of stims, my cycle is cancelled due to no response. Not poor response, but no response. My estrogen only climbs as high as 81. Due to the scheduled lab closure, I have to wait until November to try again. Fuck! Our post-cycle review appointment brings further bad news. My RE thinks that based on my response (or lack thereof) that we need to be very aggressive and plan to put back all the embryos I can make, if any. Up to 6. That absolutely freaks Hubby out and me a bit too. Our best odds for success with IVF is 15% - that's the best we get. I'm so over this and just want to be done already.

October 2006
Ah, yet another waiting cycle. I bring out the old thermometer so I'll have some idea of what's going on with my cycle and lookie there, I ovulated on time! This should time out perfectly for my IVF to start in early November. Finally, something's going right. In the 2ww, my temps are crazy high and I start to worry that my FSH is skyrocketing, that would not be good.

November 2006
On Nov 3, I'm 14dpo and temps are higher than ever. I finally give in to the POAS gods and they offer up the best reward ever - a very strong BFP! You hear about women who get pregnant on their own right before IVF, but not twice in one year! I'm scared that this pregnancy will echo the last one, but try not to stress about it. That BFP is already darker than anything I got last time. I'm supposed to be going in for cd2 monitoring on the 5th, but instead, I go in for a beta. It comes back at 331. 2nd beta is 592, we scheduled the u/s and wait and hope. First u/s shows one baby, in the uterus nice and high with a heartbeat of 128bpm, very healthy and normal - finally!

December 2006
2nd u/s shows that the baby is doing great with a heartbeat of 176bpm and measuring exactly on for dates. My 1 hour glucose screening test comes back with a very good score of 75. The NT scan shows a nice thin NT measurement. The bladder is big, but we're hoping that our streak of good news continues and the bladder measures smaller at the next u/s.

It's been quite a year and it ended waaaay better than I expected it to during most of the year. I hope that 2007 continues the positive trend, but after last year, I know not to take anything for granted and enjoy the good stuff as much as you can.